OKLAHOMA UNINSURED MOTORIST COVERAGE LAW

(Split Limit)

Oklahoma law gives you the right to buy Uninsured Motorist coverage in the same amount as your bodily injury liability coverage. THE LAW REQUIRES US TO ADVISE YOU OF THIS VALUABLE RIGHT FOR THE PROTECTION OF YOU, MEMBERS OF YOUR FAMILY, AND OTHER PEOPLE WHO MAY BE HURT WHILE RIDING IN YOUR INSURED VEHICLE. YOU SHOULD SERIOUSLY CONSIDER BUYING THIS COVERAGE IN THE SAME AMOUNT AS YOUR LIABILITY INSURANCE COVERAGE LIMIT.

Uninsured Motorist coverage, unless otherwise provided in your policy, pays for bodily injury damages to you, members of your family who live with you, and other people riding in your car who are injured by: (1) an uninsured motorist, (2) a hitandrun motorist, or (3) an insured motorist who does not have enough liability insurance to pay for bodily injury damages to any insured person. Uninsured Motorist coverage, unless otherwise provided in your policy, protects you and family members who live with you while riding in any vehicle or while a pedestrian. THE COST OF THIS COVERAGE IS SMALL COMPARED WITH THE BENEFITS!

You may make one of four choices about Uninsured Motorist coverage by indicating below what Uninsured Motorist coverage you want:

I want the same amount of Uninsured Motorist coverage as my bodily injury liability coverage.

I want minimum Uninsured Motorist coverage ($25,000.00 per person/$50,000.00 per occurrence).

I want Uninsured Motorist coverage in the following amount: $ per person/ $ per occurrence.

I want to reject Uninsured Motorist coverage.

PLEASE READ BEFORE SIGNING

In accordance with my selection and the above information, I hereby acknowledge that:

(1)  I understand the difference between the options available to me.

(2) The selection I make here, where applicable, will be binding on me and all named insureds under my Policy, despite any information to the contrary in the application for insurance, and will be in effect for every extension, reinstatement, substitution, amendment, alteration, modification, transfer, replacement or renewal of my Policy.

(3) Regardless of the number of vehicles involved, whether insured or not, persons covered, claims made, premiums paid or the number of premiums shown on the policy, in no event shall the limit of liability for 2 or more vehicles or 2 or more policies be added together, combined or stacked to determine the limits of insurance coverage available to injured persons.

______By: ______

COMPANY (NAMED INSURED) SIGNATURE

______

PRINT NAME AND TITLE DATE

THIS FORM IS NOT A PART OF YOUR POLICY AND DOES NOT PROVIDE COVERAGE.

OK-LIC-UM-1 (08/09) Page 1 of 1